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Biomedical subjects

A Oehling

Publications and source records attributed to A Oehling.

At least 163 records · Page 9Linked to original sources
PubMedDate not supplied

Food allergy and child asthma.

The etiological importance of the dietary factor as related to infantile bronchial asthma is not, at times, sufficiently taken into consideration. Nevertheless, many times foods or their components are capable of provoking asthmatic symptoms. A group of asthmatic children was studied with the goal of more throughly confirming the role of these allergens in producing bronchial asthma. Two-hundred and eighty-four patients were selected, and their clinical histories, skin tests, passive hemagglutination tests and oral provocation tests were analyzed. It was found that in twenty-four (8.45%) of these children, the etiology of their asthma was food-related, with the most frequent food allergens being eggs, milk and fish. Considering the results obtained, it was concluded that skin tests are of great value in food allergies, and that passive hemagglutination testing is of great reliability in the diagnosis of these conditions. Consequently, the allergists should always keep in mind a possible dietary etiology when treating an asthmatic child.

Adolescent↗
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Bacterial immunotherapy of childhood bronchial asthma.

In everyday practice, we usually encounter two types of childhood asthma, as regards etiology. On the one hand, primary allergic bacterial asthma and on the other, primary allergic extrinsic asthma; it is rare to encounter other types of asthma in infancy. Our point of vieew, as previously expressed elsewhere, is that the bacterial or infective factor is the most important etiologically. For this reason, we consider of major importance not only antibiotic treatment of the causative agent, but also immunotherapy with bacterial vaccines. Eighty patients were studied, 48 boys and 32 girls, aged between 2 and 10 years at the time immunotherapy was started. All had been diagnosed as having bronchial asthma of exclusively bacterial etiology, with or without associated paranasal sinusitis. In order to provide an objective estimate and evaluation of the efficacy of immunotherapy, the parents of the patients were interviewed and asked to complete the questionnaire shown in figure 1. There were 46 patients whose progress was classified as very good, amounting to 57.5%, 23 patients, or 28.7% had good results. The sume of these two groups was 69 cases, amounting to 86.2%. The remainder (fair, poor, did not complete treatment) amounted to 13.8% or 11 cases. In this last group, the highest proportion made fair progress, with 8 cases (10%). As far as tolerance to bacterial immunotherapy is concerned, in 47 cases, or 58%, no reactions occurred, while in 33 cases, or 41% of the total, side effects were observed. We should like to repeat once again that, on the basis of our results up to now, we consider the administration of appropriate bacterial immunotherapy essential as an etiological treatment in this type of asthma.

Asthma↗
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A study of the protective effect of ketotifen in food allergy.

In view of the excellent results we had obtained using KETOTIFEN in the treatment of respiratory allergies, we decided to carry out a study of its protective action in cases of allergies of purely alimentary etiology; that is, in patients symptoms only appeared after the ingestion of certain foodstuffs. The subjects of this study were 16 patients, 8 men and 8 women, aged from 13 to 49. The diagnosis of food allergy was reached by means of a clear and detailed history, skin tests, hemagglutination tests and positive oral provocation tests with the tested antigens in all patients. The basal oral provocation tests were carried out when the patients were fasting, using progressively larger doses of the antigens until a positive response was obtained, consisting of an exact reproduction of the symptomatology described in the history. After an interval of at least 10 days, a second oral provocation test was performed under identical conditions, using the same dose of antigens, after a treatment consisting of 1 capsule (1 mg.) of KETOTIFEN every 12 hours during the 5 days prior to the test. Clinical symptoms appearing singly or together in the OPT were dermal in 8 patients (50%), respiratory in 7 patients (42.85%) and gastrointestinal in 3 patients (18.75%). In 7 patients whose shock organ was the expiratory system, (group A) shows the decrease in FEV1 in each patient. It clearly shows that the patients had a smaller decrease in FEV1 after treatment, as compared with baseline values after OPT. On the other hand, 9 patients whose shock organ was the skin and the gut (group B), the protection ws complete in 6 patients (66%). The drug was well tolerated, the only side effects observed being somnolence in one patient and dryness of the mouth in another (12.5%). No changes were observed in the hemogram, ESR, blood tests, pulse, blood sugar and urinalysis. The most recent studies of the mechanism of action of KETOTIFEN are suggestive, but have not yet provided a complete explanation. This drug inhibits the release of histamine and SRS-A from mast cells, basophils and neutrophils. The fact that, as distinct from DSCG, it acts on neutrophils, inhibiting the release of SRS-A, suggests that its mode of action does not only concern those reactions mediated by IgE.

Adolescent↗
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Etiopathogenesis of atopic dermatitis in children.

According to the previous experience of the author, he affirms that the hyperergic factor plays an important role in the etiopathogenesis of atopic dermatitis and that the sensitization to foods present in 77% of the cases was the most important factor. This percentage can be seen to be potentiated by a determination of specific antibodies against the different foods by means of the passive hemagglutination tests which turned out to be positive in almost 70% of the cases. He admits of course, that psychological and all other already mentioned factors also play important accompanying roles. Lastly, he also considers that the racial factors played a very important part and that this disease affects especially those individuals with characteristics which Coca called "atopic".

Child↗
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IgG4 blocking effect on the release of antigen-specific histamine.

We evaluated the biological effect of IgG4 antibodies in pollinosis. We studied the ability of IgG4 to mediate histamine release by measuring anti-IgG4 in pollinic patients without previous immunotherapy. We also evaluated the modifications that sera rich in specific IgG4 and IgG itself exert upon antigen-specific histamine release. According to our results, stimulation with anti-IgG4 did not induce histamine release, as opposed to stimulation with anti-IgE, which induced histamine release in all the cases studied. On the other hand, hyperimmune sera from pollinic subjects under immunotherapy and with high levels of specific IgG4 significantly inhibited the release of antigen-specific histamine from basophils of untreated patients. After isolating IgG4 by means of affinity chromatography, preincubation of this fraction with the allergen gave rise to a significant reduction in histamine release compared to preincubation of the antigen with normal sera.

Antigens↗
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Influence of immunotherapy on histamine release and other immunological parameters of immediate hypersensitivity in pollinosis.

Specific immunotherapy in pollen-allergic patients leads to a significant time-dependent decrease in the seasonal differences in IgE values, that is, the shorter the duration of immunotherapy, the smaller the difference. Immunotherapy leads to a maximum specific histamine release during the first year, with higher values during the pollen season. Later, the amount of histamine released from basophils decreases gradually in relation to the duration of immunotherapy and the clinical recovery, indicating that this would be a useful parameter in the follow-up of the efficacy of this type of treatment. Inversely, total histamine, which may be considered a parameter indicating the histamine stored in basophil granules, decreases significantly, reaching its lowest values at the end of the first year, with eventual recovery to initial values. From these results we may conclude that hyposensitizing treatment should not be interrupted before 3 years, since the immunological variations of the immediate hypersensitivity parameters take place during the first 2 years, and then stabilize. On the other hand, the correlation between the degree of recovery after hyposensitizing treatment and the duration of the treatment leads us to recommend immunotherapy for periods longer than 2 years.

Hemagglutination↗
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Modulation of beta 2-adrenoceptors in human lymphocytes by in vitro stimulation with mediators.

Since Szentivanyi established the beta-adrenergic theory, many attempts have been made to explain the dynamics of bronchial hyperreactivity and cytotropic allergic reaction by this mechanism. In previous work, we found that beta-adrenoceptor numbers were decreased in symptomatic patients and after specific antigenic exposure. As a result, we postulated that this might be due to mediator activity. Blood was extracted from 46 healthy donors for this study. Radioligand [125I]-iodocyanopindolol was used for beta-adrenoceptor determination in peripheral blood lymphocytes following Brodde's method. Student's t test was used for statistical analysis. beta-Adrenoceptor number was determined before and after exposure to mediators (histamine, PAF, LTD4), and after melittin (phospholipase A2, PLA2, activator) exposure. A significant decrease was obtained after histamine (p < 0.05), LTD4 (p < 0.05) and melittin (p < 0.001) exposure; PAF did not modify the number of beta-adrenoceptors. In conclusion, our results confirm that down-regulation of beta-adrenoceptors can be induced by mediator release.

Cells, Cultured↗
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Fruit sensitization in patients with allergy to latex.

In the last years, latex has frequently been found to be involved in immediate hypersensitivity reactions. The first case mentioned with recurrent urticaria and laryngoedema was reported by Stern (1) in 1927. Since then, latex has also been implicated in generalized urticaria, rhinoconjunctivitis, asthma and anaphylaxis. Associated sensitization to several fruits is frequently seen in latex-allergic patients with the symptoms described above. This study was performed in seven patients (six females and one male) with hypersensitivity to latex and concomitant fruit sensitization. Six of them were healthcare personnel. The age of the patients ranged from 25-39 years, with a mean of 30 years. Prick tests and intracutaneous tests with latex (10% w/v in PBS), banana, chestnut, avocado, kiwi and melon were carried out. A specific histamine release test (HRT) was performed according to the fluorometric assay. Antigen-specific IgE was also performed. Latex CAP inhibition with banana and SDS-PAGE immunoblotting were carried out in one patient. Although in latex-allergic patients multiple sensitization to fruits may be observed, banana and avocado are those most frequently involved, followed by chestnut and melon. This is likely to be due to the presence of common antigens in these fruits and latex, as demonstrated in our study only for banana and avocado. We consider that further investigation is needed on the possible sensitization to latex in sanitary personnel reporting symptoms after fruit ingestion.

Adult↗
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Evaluation of total IgE in diverse allergosis. Comparative study with other techniques. Part II.

A total of 181 allergic patients were studied and classified according to the causal antigen, 92 patients were sensitized to the mixed grass pollen, 55 to house dust, 28 to Candida albicans, 31 patients with egg allergy and 25 with milk allergy. All of them presented strong positivity to anamnesis, intracutaneous tests and exposition tests. In all of them the serum total IgE was determined using the radioimmunoassay (RIST) and the antigen specific IgG, following Boyden's passive hemagglutination technique. In 31 patients with pollinosis, 55 with house dust allergy and 25 with sensitization to Candida albicans, the determination of the antigen specific IgG was also carried out following the quantitative precipitation method. The results showed a greater reliability on the hemagglutination as opposed to the determination of total IgE with grass pollen. The hemagglutination was positive in 90.20% and the total IgE was increased in 59.78% of the cases. In patients with house dust allergy the total IgE was elevated in 69.08% of the cases and the hemagglutination was increased in 60.71% of the cases. In those cases of sensitivity to Candida albicans, the total IgE presented higher values in 63.84% of the cases, while the hemagglutination was increased in 21.43% of the cases. In egg allergy,, the IgE was increased in 56.83% of the cases and the hemagglutination in 87.09% of all of the 31 cases studied. In the cases of milk allergy the IgE presented increases in 32% of the cases and the hemagglutination gave higher titers in 56% of all of the 25 cases studied. The results make evident that the hemagglutination should be included in the rutinary diagnosis of allergic diseases as well as the determination of total IgE or antigen specific IgE.

Adult↗
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The cellular immunity in patients sensitized to Candida albicans and its corresponding humoral response.

Ten non-sensitized normal blood donors and thirty five patients with a strongly positive intracutaneous test to Candida albicans, positive anamnesis to Candida allergy, or with an actual Candida infection demonstrated by positive cultures of the focus, were studied. In all of them, an evaluation of the humoral and cellular response to Candida antigens, was performed both in vivo and in vitro. The results obtained in the tests performed in the control group were considered as extreme values of a normal response and taken as reference in order to evaluate the patients' response. The results of the test performed on the 35 patients were processed in an IBM S.370/M.125 computer and submitted to a General Taxonomy Program in order to group the patients according to their characteristics and similar behaviour. Two main groups, each one including three minor groups, were obtained and only one individual was not classified. According to this classification it was possible to distinguish two immunological patterns: a) The patients that had a normal or increased percentage of T lymphocytes were capable of responding adequately to Candida albicans antigens. They showed positive immediate and delayed skin tests, increased hemagglutination titres, increased lgE values, and their lymphocytes were capable of undergoing positive blast transformation. Those patients from this group who had a candidaemia at the time of the study, reached the highest hemagglutination values and presented precipitin antibodies as a characteristic. b) The patients that had a decreased percentage of T lymphocytes presented a partial deficiency in their response to Candida albicans antigens. They showed negative delayed skin tests; hemagglutination and precipitation tests both negative, normal lgE values and their lymphocytes did not undergo blast transformation. These findings suggest that a normal percentage of T cells is required in order to obtain a suitable cellular response against Candida albicans, and that an appropriate co-operation between T and B cells is also necessary in order to obtain a good humoral response to Candida antigens.

Antibody Formation↗
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Effect of aspirin on beta-receptors in lymphocytes from patients with aspirin-induced asthma.

We studied the effect of aspirin on beta-adrenergic receptors in lymphocytes from three groups of subjects: 5 asthmatic patients presenting sensitivity to aspirin, 10 asthmatic patients with tolerance to aspirin and a control group. Lymphocytes were incubated with aspirin-lysine (36 micrograms/ml). The number of beta-receptors/cell and the dissociation constants (Kd) were assessed by means of [125I]-cyanopindolol (ICYP). There was a decrease in the number of beta-receptors after incubation with aspirin in all asthmatic patients with sensitivity. The differences between mean basal (660 +/- 171 receptors/cell) and postincubation (398 +/- 110 receptors/cell) values were significant (p < 0.05). There were also significant differences (p < 0.01) between basal (23.4 +/- 6 pM) and postincubation (15 +/- 5.1 pM) Kd values, which indicates that the affinity of ICYP increased. In the subjects in the other two groups, aspirin both increased and decreased the number of beta-receptors, but the effects were not significant. It is suggested that in patients with sensitivity, aspirin could induce changes in the plasmatic membrane, thus altering beta-receptors or inducing the release of inflammatory mediators that exert their effect upon these receptors.

Adult↗
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Modifications in IgG subclasses in the course of immunotherapy with grass pollen.

In this study, we evaluated the evolution of IgG subclasses in the course of immunotherapy, and related this to the clinical evolution. We selected 226 adult patients with sensitivity to grass pollen alone, undergoing immunotherapy for 0-26 months. The following results may be highlighted: 1) IgG1 increased with immunotherapy and reached its peak at 6 months; 2) IgG2 increased significantly, reaching its peak after 24 months of treatment; 3) IgG3, however, did not present significant modifications in the course of immunotherapy; and 4) IgG4 was high in all patients undergoing immunotherapy compared to patients without hyposensitizing treatment, the peak being reached in the group of patients with the longest course of immunotherapy. Only IgG4 showed a positive and significant (p < 0.05) correlation with the degree of clinical recovery reached with immunotherapy.

Adult↗
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IgE synthesis-enhancing factor: modification of its production in the course of long-term immunotherapy.

The isotype-specific mechanisms involved in IgE synthesis are a sophisticated system about which very little is known. Several research groups have demonstrated that there is an enhancing factor (EF) in lymphocyte supernatants which is related to the regulation of the synthesis of IgE, and the influence medium-long-term immunotherapy (IT) exerts on it. Following this line of research, we studied the influence of long-term IT (> 3 years) and the presence of interleukin-4 (IL-4), not only in the different fractions where EF is contained, but also in lymphocyte supernatants after stimulation. Bidirectional mixed lymphocyte cultures were performed between lymphocytes from healthy controls (n = 62) and allergic patients (n = 98) after different periods of IT. The supernatants obtained were submitted to affinity chromatography and the second fractions, containing EF, were added to healthy control lymphocytes (n = 11) in order to test their enhancing effect on IgE synthesis. Modifications in EF production were observed, depending on the duration of IT. There were no detectable levels of IL-4 either in EF fractions or supernatants from stimulated lymphocytes.

Humans↗
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IgE synthesis suppressor factor: modifications in the course of long-term immunotherapy.

Many authors have described an increase in total serum IgE values during the first few months of immunotherapy (IT), followed by a subsequent decrease. In previous studies in patients undergoing medium-term IT, we detected an IgE synthesis suppressor factor (SF), which was modified during the course of IT. In this study, we investigated the influence of long-term IT on the production of SF and the lymphocyte response to its stimulus. Mixed bidirectional cultures of lymphocytes isolated from healthy individuals (n = 62) and allergic patients (n = 98) were carried out after different periods of IT. The resulting supernatants were subjected to affinity chromatography, from which two fractions were obtained: the first one, likely to contain SF, was added to lymphocyte cultures from 13 allergic patients undergoing no IT (LyG1) and 6 allergic patients with > 3 years of IT (LyG5), in order to assess its inhibitory effect on IgE synthesis. We found that patients undergoing IT for > 3 years presented a significant increase in SF production and an important lymphocyte response to exogenous SF from most of the groups studied, but little response to their own SF. These results could be ascribed to an alteration in the quantity and/or structure of the lymphocyte receptors likely to be sensitive to these factors induced by IT.

Humans↗
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Modulation of beta 2-adrenoceptors in lymphocytes of allergic patients after in vitro antigenic stimulation.

In this study, we assessed the effect of antigen-specific stimulation on beta-adrenoceptors of human lymphocytes in order to study the beta-receptor atopy theory of Szentivanyi. Determination of these receptors was basically carried out as described by Brodde et al., utilizing [125I]-cyanopindolol as ligand in control and allergic patients before and after stimulation with specific antigen. We found that in vitro the specific antigen-antibody reaction induces a decrease in beta-adrenoceptors. This alteration takes place in patients with rhinitis and asthma with sensitization to Dermatophagoides and grass pollen, regardless of their baseline clinical status. Therefore, in view of the results, we question the validity of Szentivanyi's atopy theory. We hypothesize that the modification in the beta-adrenoceptor system is a consequence rather than the cause of the activity of atopic diseases.

Adult↗
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Spontaneous in vitro IgE synthesis: modifications induced by immunotherapy.

In this study, we used an in vitro experimental model with peripheral mononuclear cells (PBMCs) capable of synthesizing IgE to study the possible parallelism between in vitro IgE synthesis and the findings obtained in vivo showing changes in serum IgE values during immunotherapy (IT). Blood samples were extracted from 10 healthy subjects and 39 allergic patients for lymphocyte culture. Allergic patients were classified into five groups according to the time of IT. After incubation for 7 days at 37 degrees C, IgE values were assessed by means of a radioimmunoassay technique modified for low values. Likewise, total serum IgE was assessed. Spontaneous in vitro production of IgE in control individuals (G0) was significantly lower (p < 0.001) than the mean production in allergic patients (GA). When patients were grouped according to the time of IT, we observed that IgE values decreased during the course of IT. The significant differences found between allergic patients and control individuals eventually disappeared from the third year of treatment. We found a statistically significant positive correlation (r = 0.575, p < 0.001) between total serum IgE values and in vitro IgE production in all subjects. We conclude that IT induces a series of variations in lymphocyte IgE production in vitro, which consists of a significant decrease in IgE production from the second year of IT compared with that of patients without IT. IgE production eventually reaches levels similar to those in healthy subjects. The symptomatic recovery shown by all patients was associated with evident immunological changes, which confirms the clinical utility of this treatment in allergic diseases and the importance of its long-term effects.

Cells, Cultured↗